Insights

Influenza Vaccine Payment Allowances for 2018-2019

Posted on Wednesday, September 26, 2018 8:02 PM

CMS released the 2018-2019 payment allowances for the infulenza vaccine. The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are 95% of the Average Wholesale Price (AWP). When the vaccine is furnished in the hospital outpatient department, payment for the vaccine is based on reasonable cost.

Annual Part B deductible and coinsurance amounts do not apply for the influenza virus and the pneumococcal vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.

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